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Back to school too often means back to head lice, which children, in close quarters and sharing hats and combs, are particularly susceptible to.

If the question of how to get rid of lice leaves you scratching your head, you're not alone. The Center for Disease Control (CDC) estimates that six to twelve million infestations occur each year among children ages 3 to 11, and although head lice are not known to spread disease, the "freak out factor" remains high.

But parents who go into panic mode are prone to overspend. Let's take a closer look at the price of lice.

The Chemical reaction:
When parents spiral into panic mode, the Newton, MA-based National Pediculosis Association (NPA), a non-profit organization dedicated to preventing the misuse and abuse of pesticidal treatments for head lice, says the knee jerk reaction is to reach for chemical solutions. "This makes head lice a serious health issue for children," says Deborah Altschuler, founder of the NPA, "too often the health risks of lice come with how we respond to them." Some of those potentially dangerous treatments also result in wasted time and money.

"Many over the counter treatments contain chemicals that are not safe and don't always work," Barbara Gips, head lice removal specialist and owner of Westchester County, New York-based, The Lice Patrol, told WalletPop. "Lice have become resistant to them. If you choose to use an over the counter product, make sure you follow the directions exactly. Do not use it more often than prescribed in the instructions."

Gips warns, however, "These products do not kill nits (the eggs). You still need to remove the nits or they will hatch into new bugs and the infestation will return."

Neither is Gips a proponent of the "suffocation" method. "Home remedies such as mayonnaise and olive oil rely on suffocating lice to kill them. In addition to being messy, this method relies on waiting for nits to hatch and takes three weeks of sleeping with oil in your hair to accomplish," she explains. "If you are walking around with nits in your hair waiting for them to hatch, then you are essentially walking around with an active case of head lice."

Instead, immediate action is required. "You cannot get rid of a lice infestation by ignoring it," says Gips. "Each louse can lay up to six eggs a day in your hair. In 7-10 days, those eggs hatch into new bugs. In another 7-10 days those bugs will lay more eggs and so on, and so on. The cycle will continue and the bugs will just keep multiplying. A louse can live up to 30 days if left alone."

Gips said she does see outbreaks of lice more often during certain times of the year. "I get especially busy after children return from summer camp in August and it lasts into October. Outbreaks also increase after family vacations and family reunions over the holidays." Talk about louse-y luck.

In addition to battling the parasites, Gips also works hard at dispelling the myths that surround them. Lice do not indicate poor hygiene and their only real super power is the ability to "crawl really fast." "Lice actually prefer clean hair," says Gips, "Dirty, oily hair makes it harder for lice to latch on and lay eggs. It is also untrue that lice fly, hop and jump. "Lice do not have wings, so they can't fly and they do not have hind legs so they can't jump or hop." Additionally, Gips says, "You cannot get head lice from pets. Head lice live on human heads only. Our blood and the temperature and humidity of our heads are the perfect breeding ground for them."

it is also impossible (thankfully!) for the dreaded bugs to infest the house."It is important to remember that lice are not breeding in your furniture or infesting your house." says Gips, "The bugs can only survive for 24 hours off their human host. Vacuuming the floors and upholstered furniture and washing bedding in hot water and drying in high heat is all you need to do. You are basically trying to pick up any stray bugs or hairs that might contain lice or nits so they do not have a chance to climb back onto someone.You do not need to spend money on special furniture sprays or laundry detergents."

Gips says there is no need to throw out brushes, combs and hair accessories. "Boil water, take it off the flame and let them soak for five minutes."

Gips started her lice removal business after surviving nine bouts of lice with her own three children and helping friends and relatives with theirs. "I learned more and more about how to effectively treat them each time," said Gips who explains it was during one such episode she experienced her "Aha! moment."

Greener methods
"I figured out a system that worked which was non-toxic ... more effective at killing and removing lice than anything else I had tried, and best of all, my kids didn't mind it."

She begins her lice and nit removal process with meticulous combing and a thorough inspection. "I start with an enzyme shampoo that loosens the glue which holds the nits on to the hair and softens the exoskeleton of the lice bugs. Then, I comb out the lice and nits using a metal nit comb. After I rinse out the shampoo and blow dry the hair, I perform another strand-by-strand inspection for any remaining nits or bugs that the comb did not get out and pull them out by hand. Then I end with a special [all-natural] oil that I comb through the hair to slide out any remaining bugs, should there be any. It only takes a couple of hours for the infestation to be removed and children and parents can return to school and work the next day." The Lice Patrol charges $125 for the first hour, and $100 each hour after that. The service also instructs clients on how to perform required follow-up maintenance and gives them the necessary tools and products.

If a family can't afford to hire a nit-picking pro, Gips suggests they find a natural, treatment shampoo and invest in a good metal nit comb. "Combing is the key to lice removal," says Gips. "They will need to comb until they are not seeing anymore lice or nits. They should continue combing every day for 2 -3 weeks to be sure the infestation is gone."

Last month, the NPA launched its 2010 Comb First! campaign aimed at helping parents understand the importance of combing to combat lice. The organization sells the LiceMeister comb ($8.95), along with comb cleaning accessories ($4.40) and DVD of instructional materials ($19.95) on their website with proceeds going to support their program outreach, prevention and research. The site also features free video demonstrations, answers to frequently-asked questions, as well as funny poems, stories and lice-themed games for kids.

The Salon Method
Although the NPA's DIY approach definitely offers the most cost effective approach to treating head lice, there remain those who are willing to pay well to get rid of the little buggers. Hair Wizards Salon in Southern Calif., Love Bugs Salon in Northern Calif., the Texas Lice Squad in Dallas and Missouri City, and nation-wide chain, Hair Fairies, are a few of the growing number of clinical salons dedicated exclusively to removing head lice. Hair Fairies will also make house calls, and sell their products online ($12 Nit Zapping Comb up to $120 for the all-inclusive Home Deluxe Kit).

When calling the Hair Fairies Salon in Chicago, I was informed that most medical Flexible Spending Accounts (FSA's) and some medical plans will cover the costs of lice removal services. Hair Fairies charges $75 dollars per hour, and then $23.75 in 15 minute increments. Their treatment begins with an initial screening followed by three treatments over a one-and-a-half week period. Four treatments are required for a severe infestation. Their work, like most removal services, is 100% guaranteed.

One colleague recently reported there had been an outbreak of lice at her child's school and a letter was sent home recommending that everyone's hair be washed in vinegar and anything that can't be machine washed in hot water (i.e. certain stuffed animals, dolls or toys) should be sealed in plastic for 20 days. That's quite a time out.

Online website, Headlice.org said,"Experts used to suggest bagging items such as stuffed animals for a number of weeks to help bring infestations under control. Since lice cannot survive without human blood, this is unnecessary. Vacuuming is a sufficient safeguard for any questionable areas or items that may be in contact with those who are infested. You can also put bed linens, stuffed animals and other items in a dryer for 30 minutes," suggests the site. "Save your physical and emotional energies for screening and thorough lice and nit removal."

I asked Barbara Gips what she thought of the directive. "Vinegar is an enzyme, so it works to help loosen the nits on the hair and makes it easier to comb them out, similar to the shampoo I use but not as effective," says Gips. "You have to dilute the vinegar 50% with water. It smells pretty bad and is very drying to the hair. It also does not kill bugs or nits. You still have to remove them."

Online resource site, KidsHeadLice says the vinegar technique does dissolve the nit "glue" that helps hold the eggs onto the hair shaft, and believes it is better then nothing as a pre-combing treatment. "Loosening nits is well worth it," says the site, "because combing is such a pain. If I didn't have access to an enzyme shampoo, I'd try white vinegar." The site suggests either saturating the scalp with white vinegar and rinsing, or leaving the vinegar on the head for one to two hours wrapped in a towel.

Bottom line, the NPA hopes parents will practice early intervention and check for lice regularly. "With an effective combing tool in hand," the NPA suggests, "early detection with thorough manual removal of lice and nits is still the best response."